Historic Dispute : Did syphilis originate in the New World, from which it was brought to Europe by Christopher Columbus and his crew

Historic Dispute : Did syphilis originate in the New World, from which it
was brought to Europe by Christopher Columbus and his crew?

Photo by: haveseen

Viewpoint:
Yes, syphilis originated in the New World and was brought to Europe by
Christopher Columbus's crew.

Viewpoint:
No, syphilis was a disease that had long been in the Old World; it was
simply a coincidence that it flared up shortly after Columbus's
return from the New World.

Since the emergence of HIV/AIDS (human immunodeficiency virus/acquired
immune deficiency syndrome) in the 1970s, interest in the origin of
syphilis has grown because of parallels between the history of syphilis
and that of AIDS. Both diseases seemed to arise suddenly and spread
rapidly, causing severe illness and death. Scholars have suggested that
understanding the history of syphilis might provide a guide for AIDS
policy. Today, AIDS, syphilis, and gonorrhea are considered the major
venereal or sexually transmitted diseases, but other venereal diseases,
such as genital herpes, trichomoniasis, nongonococcal urethritis,
chlamydia, chancroid, lymphogranuloma venereum, and granuloma inguinale,
can also cause serious complications. The term "venereal"
has long served as a euphemism in matters pertaining to sex. In the late
twentieth century, the phrase "sexually transmitted disease"
officially replaced the older terminology. Although both terms have been
applied to diseases that are incidentally transmitted by sexual contact,
such as scabies and crab lice, a more restricted definition includes only
those diseases that are never, or almost never, transmitted by any other
means.

Syphilis and the Renaissance

Syphilis has been called many things, including the "Scourge of
the Renaissance." European art, culture, science, and scholarship
were transformed during the period known as the Renaissance. This period
is also remarkable for its changing patterns of epidemics and its vivid
reports of apparently new and violent diseases. In part, the expanding
medical literature is associated with the invention of the printing
press in the early 1400s, one of the inventions that helped transform
the medieval world. The printing press made it easier to disseminate
reports of new diseases. Diseases previously rare, absent, or
unrecognized—such as syphilis, typhus, smallpox, and
influenza—became major public health threats. No disease raises
more intriguing questions than syphilis, a disease that traces the
hidden pathways of human contacts throughout the world, and the intimate
links between social and medical concepts.

Despite the number of historical references to venereal diseases, many
Renaissance physicians were convinced that syphilis was unknown in
Europe until the end of the fifteenth century; others argued that there
was only one "venereal scourge," with variable
manifestations. The confusion is not surprising, given the natural
history of the major venereal diseases.

The Symptoms of Syphilis

Syphilis has been called the "great mimic" because its
symptoms are similar to those of many other diseases. In fact,
before the introduction of specific bacteriological and immunological
tests, many physicians believed that "whoever knows all of
syphilis knows all of medicine." Untreated, syphilis progresses
through three stages of increasing severity. A small lesion known as a
chancre is the first stage. The second stage involves generalized
symptoms, such as fever, headache, sore throat, skin lesions, and
swollen lymph nodes. Severe damage to major organ systems occurs in
tertiary syphilis. Confusion between gonorrhea and syphilis has been a
major theme in the history of venereal disease, but there is little
doubt that gonorrhea is a very ancient and widespread disease. Fritz
Richard Schaudinn (1871-1906) and Paul Erich Hoffmann (1868-1959)
discovered the spirochete that causes syphilis in 1905. One year later
August von Wassermann (1866-1925) discovered a specific blood test for
the disease.

Early Descriptions

When accounts of syphilis appeared in the sixteenth century, the disease
was known by many names, including the "French disease,"
the "Neapolitan disease," the "Great Pox,"
and "lues venereum." Syphilis, the name used today, was
invented by Girolamo Fracastoro (1478?-1553), an Italian physician,
scientist, and poet. An acute observer of plague, typhus, and other
contagious diseases, Fracastoro was a pioneer of epidemiology (the study
of the spread of epidemic diseases) and an early advocate of the germ
theory of disease. In
On Syphilis, or the French Disease
(1530), Fracastoro created the story of Syphilis the shepherd, whose
blasphemy brought about the first outbreak of the scourge. Ever since
Fracastoro described the disease, its natural history, mode of
transmission, and contemporary remedies, medical historians have debated
the same questions: when and where did syphilis originate?

The "Columbus Theory"

According to sixteenth-century medical astrologers, a strange
conjunction of Jupiter, Saturn, and Mars produced a toxic miasma, or
poisonous gas, that brought a new epidemic disease to Europe. Even
today, astrologers might argue that this theory has never been
disproved. Another sixteenth-century theory was based on the idea that
the New World was the source of new diseases, as well as new plants and
animals. The expansion of commerce, travel, and warfare that
characterized the fifteenth century transformed patterns of epidemic
disease. Thus, many Renaissance physicians adopted the "Columbus
Theory" as an answer to the origin of syphilis; that is, they
assumed that Christopher Columbus and his crew had imported syphilis
from the New World to the Old World.

Fracastoro recommended mercury as a remedy for syphilis, but many other
physicians favored an expensive remedy known as "Holy
Wood," which was made from the bark of trees indigenous to the
New World. According to the ancient Doctrine of Signatures, if syphilis
originated in the New World, the remedy should be found there.
Therefore, physicians and merchants who profited from the use of Holy
Wood were staunch advocates of the Columbus Theory.

The Columbus Theory appeared to explain many observations about
syphilis, but critics argued that coincidence should not be confounded
with causation. Some historians blamed the physical and mental
deterioration of Columbus on syphilis, but other explanations are
equally plausible. Rodrigo Ruiz Diaz de Isla (1462-1542) was one of the
first physicians to assert that members of the crew of Columbus had
imported syphilis to Europe. Although de Isla claimed that he had
treated sailors with a new disease in 1493, he did not publish his
observations until 1539.

The "French Gonorrhea"

Circumstantial evidence supported the Columbus Theory, but Fracastoro
argued that there was significant evidence that syphilis was not an
imported disease. The physician and alchemist known as Paracelsus
(1493?-1541) called the new venereal disease "French
gonorrhea" and suggested that it arose through sexual intercourse
between a leprous Frenchman and a prostitute with gonorrhea. Some
physicians thought that the disease that was diagnosed as syphilis in
the sixteenth century might have been misdiagnosed as leprosy in
previous eras. Allusions to "venereal leprosy" and
"congenital leprosy" before 1492 suggest that some
medieval "lepers" might have been syphilitics. To
determine the validity of this theory, scientists have looked for
syphilitic lesions in bones found in leper cemeteries throughout Europe
and the Middle East.

The "Unitarian Ancestral Treponematosis Theory"

Two other interesting theories of the origin of syphilis require some
knowledge of the causative agent of the disease as well as its natural
history. These theories are known as the "African, or Yaws
Theory" and the "Unitarian Ancestral Treponematosis
Theory." If diseases were catalogued in terms of etiological, or
causative, agents instead of means of transmission, syphilis would be
described as a member of the treponematosis family. The treponematoses
are diseases caused by members of the
Treponema
group of corkscrew-shaped bacteria known as spirochetes. The four
clinically distinct human treponematoses are syphilis; yaws and pinta
(contagious diseases commonly found in the Tropics); and bejel (or
nonvenereal endemic syphilis). Some bacteriologists believe that these
diseases are caused by variants of an ancestral spirochete that adapted
to different patterns of climate and human behavior. Syphilis is caused
by
Treponema pallidum
; bejel by
Treponema pallidum endemicum
; yaws by
Treponema pertenue
; and pinta by
Treponema carateum
.

The Yaws Theory

According to the African, or yaws theory, syphilis was the result of the
unprecedented mixing of the germ pools of Africa, Europe, and the
Americas. With the Native American population decimated by smallpox and
other Old World diseases, Europeans began importing African slaves into
the New World within 20 years of the first contacts. If Africans taken
to Europe and the New World were infected with yaws, changes in climate
and clothing would have inhibited nonvenereal transmission of the
spirochete. Under these conditions, yaws could only survive by becoming
a venereal disease.

Skeletal Evidence

The Columbus Theory requires, at the very least, conclusive proof of the
existence of syphilis in the New World before 1492; unequivocal evidence
of syphilis in Europe before the voyages of Columbus would disprove this
theory. Human skeletal samples provide the bulk of the evidence for the
presence of various diseases in pre-contact America and Europe. During
the 1990s bones with diagnostic signs consistent with syphilis were
discovered in some allegedly pre-Columbian skeletons in several European
burial grounds. However, few diseases leave a characteristic mark in the
bones, and different diseases may produce similar lesions. If the
diagnosis and dating of skeletons in these European sites can be
confirmed, it would mean that syphilis was present in both the Old World
and the New World before the voyages of Columbus. However, given the
difficulties inherent in paleopathology, many researchers argue that the
diagnostic evidence for syphilis in pre-Columbian America and Europe
remains problematic. Although partisans of various theories present many
ingenious arguments, many experts believe the evidence is not yet
compelling. Some historians argue that despite advances in understanding
the treponematoses, medical detectives are no closer to a definitive
account of the origin of syphilis than medical authorities are to
eradicating sexually transmitted diseases.

—LOIS N. MAGNER

Viewpoint: Yes, syphilis originated in the New World and was brought to
Europe by Christopher Columbus's crew.

The question of the origin of syphilis has been energetically debated
since the disease first appeared in Europe in the late fifteenth
century, ravaging the continent with an epidemic of great virulence.
Charles VIII, the Valois king of France, invaded Italy in 1494 with an
army of over 30,000 mercenary soldiers hired from all over Europe.
Charles's army reached Naples, which was primarily defended by
Spanish soldiers, in early 1495. After holding the city for a few
months, Charles's forces retreated; by early summer King Charles
had disbanded his army and returned to France. Unfortunately, his
soldiers were infected with a mysterious disease, one so new that
doctors had no name for it.

Initially called "the Neapolitan disease," over the next
centuries the disease would be known by an extensive variety of terms,
with "the French sickness" and "the great
pox" being the most common. Although it was not until the
nineteenth century that the name "syphilis" was
universally accepted, to avoid confusion the term
"syphilis" will be used throughout the essay. Regardless
of the many names employed, as Charles's mercenaries returned to
their native lands or moved elsewhere to wage war, they spread the
disease throughout all of Europe in what quickly became a major
epidemic. Since this was a period of European expansion, known as the
Age of Exploration, syphilis was soon carried by European sailors into
the non-European world, reaching India and China by 1504.

Symptoms of Syphilis

Contemporaries of the initial epidemic agreed on two things: The first
was that the disease was venereal; that is, it was spread by sexual
intercourse. The first noticeable symptom of syphilis was (and still is)
the development of a chancre or raised pustule on the genital organs of
both male and female victims. The second factor agreed upon by all
commentators was that syphilis had a frightening impact on the body.
After some time, the first chancre would disappear, but new sores would
develop over the body, especially on the face. This second period was
coupled with great pain in the bones and often ended in death. Alexander
Benedetto, a papal doctor, reported in 1497 that he had seen victims who
had lost hands, feet, eyes, and noses because of the disease. Syphilis,
he remarked, made "the entire body so repulsive to look at and
causes such great suffering … that this sickness is even more
horrifying than incurable leprosy, and it can be fatal."
Europeans were terrified of syphilis. Scores of local rulers and
municipal governments quickly issued decrees banning those with the
disease from their territories.

These early symptoms of syphilis are important in determining the origin
of the disease. After several decades, the severity of the symptoms
began to abate. Documentary evidence establishes that syphilis was much
more severe in the first half of the sixteenth century than it has ever
been since then. This epidemiological pattern is consistent with the
behavior of a disease in
an area that has never experienced it and whose inhabitants thus have
no immunity to it. The disease loses its virulence over time as
people's bodies begin developing some protective immunity to it.
This indicates that until 1495, Europeans had never suffered from
syphilis. The bone pains are of even greater significance in determining
the disease's origin. Syphilis is one of several diseases that
modifies bone structures by causing skull and bone lesions. As will be
seen, the existence of these bone lesions will ultimately settle the
debate over the origin of syphilis.

Oviedo's New World Theory

This debate had divided doctors and other learned authorities since the
onset of the disease. Some adopted the usual bromide that syphilis had
been inflicted upon humans as punishment for their sins, in particular
for their sexual transgressions, given the venereal nature of the
disease. Others relied on an astrological explanation, holding that
epidemics were the result of unfortunate alignments of planets. However,
a new theory of the disease's origin appeared in 1526 with the
publication of Fernández de Oviedo y Valdés's
Summary of the Natural History of the Indies,
in which Oviedo, who spent over a decade in Hispaniola as a Spanish
administrator, wrote: "[You] may take it as certain that this
malady comes from the Indies" and that it was brought to Europe
by Columbus's sailors. Rodrigo Ruy Diaz de Isla made exactly the
same claim in his
Treatise on the Serpentine Malady
(1539). Together these two publications initially proposed the New
World, or Columbian, theory of the origin of syphilis.

Opponents of this thesis have attacked it on the basis of the timing of
its first appearance. Why, they question, did over 30 years pass after
Columbus's first voyage before this hypothesis was proposed?
There is strong evidence that de Isla, a Spanish doctor, wrote his
account in 1506 or earlier, even though it was not published until more
than three decades later. Hence, his claim to have treated men who had
sailed on Columbus's first 1492-1493 voyage and who had developed
syphilis upon their return was written relatively soon after the event.
He also claimed to have treated individuals suffering with syphilis in
Spain before Charles VIII's invasion of Italy, implying that it
was Spanish soldiers who carried the disease to Naples. While this is
not incontrovertible evidence for the New World theory, it is difficult
to imagine why Diaz de Isla would fabricate his account.

Other critics of the New World theory have pointed out that Oviedo had
purchased considerable amounts of land in Hispaniola. In his writings
Oviedo stated, correctly, that the natives of the island, the Taino,
believed that wood from the guaiac trees which grew there could cure
syphilis. Oviedo subsequently formed a partnership with the Fuggers of
Augsburg (a family of prominent German financiers and merchants) and
obtained a monopoly to import guaiac wood into the Holy Roman Empire.
Critics claim that Oviedo was exploiting the popular belief that for
every harmful affliction, God had placed a cure nearby. If Oviedo could
establish that syphilis came from the New World then, according to this
assumption, the cure would come from there as well. He stood to make a
fortune importing the wood into Europe. However, these critics have
failed to question the origin of the idea that guaiac wood cured
syphilis. It would only be prevalent among the Taino people if syphilis,
or something like it, also existed there. Nor do these critics take into
account the fact that a German author named Nicholas Poll claimed in
1517 that guaiac wood from Hispaniola reportedly cured the disease.

The Old World Hypothesis

Even before the New World theory was advanced, a number of authors
claimed that syphilis had been present in Europe since the time of the
ancient world. Those holding this thesis of an Old World origin used
passages from the Bible, Galen's writings, medieval texts and
works of literature, and Arabic sources to demonstrate that the
"new" venereal disease had always been present in Europe
and the Mediterranean area. Essentially, their argument was that the
descriptions of leprosy and other afflictions in these ancient sources
were really misdiagnoses of syphilis. They combed all sorts of literary
sources for evidence, much of which even some present-day defenders of
the Old World hypothesis admit is often forced and unconvincing.

In the rapidly developing polemic over origin—there were 58 books
on syphilis published
by 1566—neither side could offer irrefutable evidence to win the
debate. But the "American," or Columbian, theory was
certainly more persuasive than the labored literary interpretations of
the Old World adherents, and by the eighteenth century, belief in the
New World origin of syphilis was very widely held. Both Montesquieu and
Voltaire accepted the Columbian theory, and for good reason: In their
1988 exhaustive review of the controversy, modern scholars Baker and
Armelagos conclude that, with regard to reliance on the documentary
evidence of written sources, "the case for pre-Columbian syphilis
in the Old World rests solely on vague and ambiguous disease
descriptions and must, therefore, be rejected."

The controversy was far from over, however. In the second half of the
nineteenth century, microbiology emerged as a new scientific field. With
the formulation of the germ theory, with Robert Koch's
demonstration that specific diseases were caused by different bacteria,
and with the development of improved microscopes, research into syphilis
yielded valuable information. By 1905, it had been discovered that the
spirochete bacterium
Treponema pallidum
caused syphilis and could only be contracted either through sexual
intercourse or congenitally. It was soon learned that other treponemata
were the agents that produced the diseases yaws and pinta, both of which
were endemic to the American tropics and both of which were present on
Hispaniola at the time of Columbus's first voyage. These bacteria
are so similar that even under today's high-powered microscopes
they are still indistinguishable. Evidence also accumulated that under
changed environments, treponemata could mutate from one form to another.
So
Treponema pertenue,
the bacterium that caused yaws in Hispaniola, might mutate to
Treponema pallidum
in Europe's climate, thus causing syphilis there.

Archaeological Evidence

As indicated earlier, syphilis is one of the diseases that causes
abnormal changes in bone structure. Its lesions leave skeletal evidence
of its presence, as do diseases such as yaws and conditions such as
lithopedion. Although the documentary evidence indicated a New World
origin of syphilis, adherents of the Old World origin argued that this
evidence was not absolutely conclusive. This being the case, from the
1890s to the present the focus of the debate shifted from a search for
literary sources to the field of archaeology, the study of ancient
history through the examination of physical remains. As archaeology
developed as an independent science in the late nineteenth century, its
practitioners learned that skeletal remains could reveal a great deal
about past events and provide information that written sources could
not.

If bones and skulls were found in the Americas with lesions indicating
the presence of syphilis before 1492, but could not be found in the Old
World prior to that date, then the Columbian origin of syphilis would be
conclusively proven. If, however, the reverse were the case, then the
Old World theory would hold sway. That is, if pre-1492 skeletal evidence
was found in the Old World with syphilitic lesions but not in the
Americas, then obviously the disease could not have come from
Hispaniola. If pre-Columbian skeletal evidence of syphilis was found in
both areas, the Old World case would be strengthened to the point that
it could be demonstrated that while syphilis may not have originated in
Europe, it was not a fifteenth-century New World import.

The results of this century-long search of archaeological sites in both
Europe and the Americas have demonstrated the validity of the New World
thesis of syphilis's origin. Numerous sites in the Americas
stretching from New York to Peru have provided an abundance of skeletal
evidence indicating the pre-1492 existence of the treponemata diseases
of yaws and syphilis. On the other hand, no pre-Columbian skeletons
bearing syphilitic lesions have been found in Europe. For example, in an
exhaustive study made in the 1970s and 1980s in Czechoslovakia of over
10,000 skeletons found in medieval cemeteries, no evidence of syphilis
was found. These findings conclusively demonstrate the New World origin
of the disease.

Occasionally a news item will appear claiming that pre-Columbian bones
with lesions indicating that the individual suffered from syphilis have
been found in Europe, and the debate will momentarily flare up. However,
over time it invariably turns out that the lesions were caused by some
other disease or condition. In 1996, for instance, it was announced that
the skeleton of a seven-month-old fetus dating from the fourth century
was found in Costebelle, France, bearing lesions from congenital
syphilis. If true, this would have certainly revived the Old World
hypothesis. However, a leading paleopathologist examined the skeleton
and convincingly demonstrated that the bones were deformed by a case of
lithopedion, an extremely rare and fatal occurrence related to the
extrauterine formation of a fetus in the abdominal cavity; the fetus was
not a victim of congenital syphilis. More recently, in August 2000,
English paleopathologists announced that lesions of skeletons excavated
at a friary in Hull proved the existence of syphilis in Europe by about
1475. In this case, however, the dating is uncertain, and some
scientists believe the disease involved may have been bejel, which is
prevalent in North Africa. Hence, while this discovery has refocused
interest in the debate, it does not appear to be a viable threat to the
New World thesis.

There is still, however, some debate among the adherents of the New
World theory. A small group of New World theorists advocate what is
sometimes referred to as the "unitary" hypothesis. This
theory maintains that following their sexual assaults on the Taino
women, Columbus's men were infected with yaws, which is spread by
skin contact. When these sailors returned to Europe, environmental
changes caused the bacterium to mutate into the form that causes
venereal syphilis, for which the Europeans had no immunity. Baker and
Armelagos hold this position, concluding that "nonvenereal
treponemal infection is a New World disease that spread to the Old World
and became a venereal disease following European contact." While
somewhat modifying the New World theory, this "unitary"
position does not vitiate it because it holds that without contact with
the diseases of the American tropics, there would have been no initial
epidemic of syphilis in Europe.

However, leading paleopathologists, such as Bruce and Christine
Rothschild, argue that the causal agent of yaws and/or pinta had
undoubtedly mutated and was causing syphilis in the West Indies long
before Columbus arrived. Their examination of almost 700 skeletons from
various New World sites convinced them that venereal syphilis was
present in the tropical Americas at least 800 (and possibly as many as
1,600) years ago. They, and many other archaeological medical
detectives, strongly claim that syphilis originated as a New World
disease, most plausibly from a mutation of yaws. Thus Columbus's
crews, after their brutal mistreatment of Taino women, proved to be the
vector for the introduction of syphilis into Europe, where the disease
had never been encountered. From there it was carried around the world.

—ROBERT HENDRICK

Viewpoint: No, syphilis was a disease that had long been in the Old
World; it was simply a coincidence that it flared up shortly after
Columbus's return from the New World.

Controversies often occur over scientific issues where there is evidence
on both sides of the question, but the evidence is not overwhelming on
either side. In the case of medical controversies that involve the
history of diseases such as syphilis, it is frequently difficult to
obtain compelling evidence because descriptions of the diseases written
in the distant past are usually vague since writers lacked the precise
vocabulary to describe symptoms that is available to medical writers
today. Thus it is difficult to make a confident diagnosis on the basis
of these early writings. In addition, these descriptions are frequently
based on ideas about disease processes that are often different from
those we accept today, when evil spirits and punishment for
sin—often cited as causes of syphilis—are not seen as
valid topics for discussion in medical analyses. Also, at times the
symptoms of more than one condition may have been described as signs of
a single disease. For example, the symptoms of the two sexually
transmitted diseases syphilis and gonorrhea were often confused and
combined. This is not surprising since they both can be contracted
through sexual intercourse, so it is very possible that the same person
could be suffering from the two infections simultaneously. It was not
until the creation of improved microscopes in the nineteenth century and
the development of chemical tests for these diseases in the twentieth
century that doctors were able to clearly differentiate between these
two bacterial infections.

What Is Syphilis?

Despite the problems involved in diagnosing the diseases of the past,
there is a great deal of convincing evidence that syphilis was a disease
that had been present in Europe long before Columbus's time, thus
making it a disease of the Old World rather than of the New. In order to
present this case, some background on the symptoms and course of the
infection is useful. Syphilis is caused by a spiral-shaped bacterium, a
spirochete, of the species
Treponema pallidum pallidum
. The corkscrew shape may explain why
T. pallidum pallidum,
unlike most other bacteria, can pass through the placenta into a
developing fetus and cause abnormal development and even miscarriage.
This bacterium is a delicate organism that can only survive on warm,
moist tissue, which is why it is spread through sexual intercourse. The
infection it causes is a slow one, with a series of stages during which
the host's immune system attempts to fight off the bacteria,
though the bacteria often survive in the body to flare up later. Until
the antibiotic penicillin became available in the mid-1940s, there was
no effective treatment for syphilis, no effective way to stop the
bacterium from causing its later and more damaging effects. Mercury
compounds could slow the infection somewhat, but mercury is itself a
poison that can damage the nervous system, so this is definitely a case
where the cure was, if not worse than the disease, at least as harmful.

Though the course of syphilis varies widely from individual to
individual and not everyone experiences all the symptoms, the normal
course of the disease begins with a chancre or raised pustule that
usually develops a few weeks after exposure at the site where the
bacteria entered the body—in other words, the chancre usually

appears on the genitals. Even if the disease is left untreated, the
chancre disappears after several days. Three or four months later a rash
and low-grade fever may develop, sometimes accompanied by inflammation
of the joints. These are the symptoms of secondary syphilis and are
signs that the spirochete has moved from the skin into the blood stream
and that the immune system is now mounting a whole-body rather than a
localized attack against the bacteria.

One third of those with untreated syphilis seem to suffer no further
problems after secondary syphilis and show no further evidence of the
disease. Another third continue to have what is called a latent
infection, which means that while there are no symptoms, they still test
positive in blood tests for the infection. Months or years after
secondary syphilis, the third group of patients develops tertiary
syphilis, in which the immune response to the continuing presence of
these spirochete bacteria can lead to destruction of the bones, the
nervous system, and the heart and blood vessels, leading to
disfigurement and crippling, paralysis and blindness, and ultimately to
death.

One other point is important to keep in mind about syphilis when
weighing evidence as to its origins:
T. pallidum pallidum
is very similar to the organism
T. pallidum pertenue,
which causes a non-sexually transmitted disease called yaws. The names
of these two organisms indicate just how similar they are: they are two
varieties of the same species,
T. pallidum
. Yaws is now common only in the tropics as a skin disease in children,
though, like syphilis, it can have long-term effects and can cause
damage to the bones.

Not a "New" Disease

The major point in the argument of those who see syphilis as originating
in the New World and reaching Europe through the men who had accompanied
Columbus on his voyage of discovery is that beginning in 1495 and
extending into the first decades of the 1500s, syphilis spread
throughout Europe, and at least some observers of the time considered it
a new disease. But there are problems with this view, including the fact
that it was not until this new wave of syphilis had existed for at least
15 years that observers began to speculate that it was a new disease
carried back to Europe by Columbus. In addition, the debate over ancient
versus Colombian origins for European syphilis did not intensify until
the seventeenth century. This seems odd; if it was in fact so different
from the diseases of the past, why was this not noted immediately? Also,
could a disease that is relatively slow in the development of its
symptoms have spread so fast throughout Europe, to be widespread by the
late 1490s when Columbus had only returned in 1493?

What everyone does agree on is that the form of syphilis which spread at
the time was much more dangerous and deadly than it had been in the past
or was to become in the future. Spread by sexual contact, it was highly
contagious and caused pustules, pain, and itching of the skin, often
spreading all over the body. These symptoms were followed by intense
pains and a deterioration of the bones. This stage of the disease often
ended in death. A possible explanation for these symptoms is not that
they were caused by a new disease, but by a more virulent or deadly form
of a long-occurring organism. This is not an uncommon phenomenon among
bacterial infections, with a modern-day example being that of
Staphylococcus aureus
, in most cases a relatively harmless organism commonly found on the
skin. But there is a deadly form of
S. aureus
responsible for toxic shock syndrome, an often-fatal infection that
surfaced in the 1980s.

When a more virulent form of
T. pallidum pallidum
did arise in Europe at the end of the fifteenth century, the political
conditions were ideal for its spread. There were large armies amassing
in several areas and large-scale troop movements. Wherever there are
armies there are likely to be illicit sexual activities that spread
sexually transmitted diseases; these, coupled with troop movements,
hastened the spread of syphilis. Descriptions recorded by firsthand
observers at the time tell of patients with many pustules, rather than
the single pustule usually seen today, and with the symptoms of rash and
painful swellings that are now associated with secondary syphilis
occurring much more rapidly than they do today. After about 50 years,
this particularly virulent form of syphilis seems to have subsided and
was replaced by the more slowly progressing form that we see today.

Biblical and Other Ancient Evidence

But is there evidence of syphilis in any form present in Europe and
other parts of the Old World before the end of the fifteenth century?
Those who support the hypothesis that it was the return of
Columbus's expedition that triggered the outbreak of syphilis
claim that there is no such evidence, but this view ignores a great deal
of information pointing to the presence of this disease in Europe, the
Middle East, and elsewhere in the Old World for centuries and maybe even
longer. There are many reports in the Bible and other writings of a
disease in which there are pustules and swellings, quite reminiscent of
syphilis. In the recent study
Microbes and Morals,
Theodore Rosebury argues that while there are many passages in the
Bible that can be more accurately seen as descriptions of syphilis than
of any other infection we know of today, the descriptions of the plagues
in Egypt and in Moab are the most detailed and convincing passages
on syphilis. These plagues are described as causing scabs and itching,
perhaps as a result of chancres and rashes. There are also descriptions
of madness, blindness, and "astonishment" of the heart,
which could be interpreted as heart failure—all three of these
symptoms are related to tertiary syphilis. In describing the plague of
Moab, there are many references to loose sexual practices leading to
disease, another indication that the infection involved was syphilis.

Those who support the Colombian origin view argue that many of the
passages cited by the anti-Colombian advocates describe leprosy, not
syphilis. Admittedly, it is difficult to make a specific diagnosis one
way or the other on the basis of sketchy descriptions, but a few details
are telling. One is that in some cases, there are Medieval and biblical
reports of the disease being transmitted to unborn children. This is
never the case with leprosy, but it is possible with syphilis since the
spirochete can penetrate the placenta. Also, a number of historians have
amassed a large collection of evidence that syphilis was known in
ancient China and Japan, and was familiar to Hindus and to ancient
Greeks and Romans. This evidence includes comments on the
disease's relationship to sexuality and to birth defects, both
hallmarks of syphilis as opposed to other diseases with which it might
be confused, including leprosy and the plague. Such reports are likely
to be documenting cases of syphilis in the ancient world and throughout
Asia.

Skeletal Remains

There is also more solid evidence rather than just verbal reports. In
2000, British researchers unearthed 245 skeletons from a cemetery in
northeastern England. Three of these skeletons showed clear signs of the
type of damage associated with syphilis, with 100 more showing slight
indications of such damage. Radiocarbon dating was used on the skeleton
showing evidence of the most severe disease and revealed that the man
died sometime between 1300 and 1450, well before Columbus's
voyage. Some argue that the bone lesions could be the result of yaws
rather than syphilis. But the same argument can be used against a
favorite piece of evidence presented by pro-Colombian advocates: the
discovery of syphilis-like skeletal lesions in bones dated to
pre-Columbian times and found in various parts of South, Central, and
North America. Advocates contend that this proves that syphilis was
present in the New World before the time of Columbus, a view that some
anti-Colombians argue against. So it would seem that the physical
evidence from bone lesions is less than convincing on either side of the
dispute.

Of course, the presence of syphilis in England in the fourteenth and
fifteenth centuries does not necessarily mean that the infection was
present in Europe from ancient times. Still another hypothesis, somewhat
of a compromise between the Colombian and anti-Colombian views, is that
it was not Columbus but the Vikings who brought syphilis back from the
New World. There is evidence that the Vikings had reached
Canada's eastern shores hundreds of years before
Columbus's voyage, and they began trading in northeastern England
around 1300, which was about the time the recently discovered skeletons
started to show signs of the disease.

There may eventually be a resolution of this controversy thanks to
molecular genetics. In 1998, the genome, or genetic makeup, of
T. pallidum pallidum
was completely deciphered, so biologists now have a record of all the
information in the genes for the organism that causes syphilis. The same
information is now being accumulated for
T. pallidum pertenue
, the cause of yaws. When this sequence is deciphered, researchers can
hunt for bacterial DNA (deoxyribonucleic acid—the nucleic acid
found in the nuclei of all cells) in the bones that have been unearthed
in England and at other sites and determine which sequence most closely
matches the bacterial DNA from the bones.

In one sense it would be disappointing if such information finally
settled this centuries-old disagreement. As R. R. Wilcox, who argued
against the Colombian hypothesis, wrote over a half a century ago:
"It would be a great pity if someone did produce irrefutable
evidence for either side and thus prevent any further such interesting
speculation."

SYPHILIS AND AIDS: SOME INTRIGUING SIMILARITIES

Although syphilis is caused by a bacterium while the causative agent of
acquired immune deficiency syndrome (AIDS) is the human immunodeficiency
virus (HIV), there are intriguing similarities in the ways these
diseases have afflicted humans. Both erupted suddenly in Western
societies: syphilis in Europe in the 1490s; AIDS in the United States in
the early 1980s. In both instances, medical experts were baffled over
the cause of the new disease. Within a decade of their initial
appearance, both diseases became pandemic, spreading rapidly around the
world creating a global calamity of massive proportions. In each case,
this dispersion was facilitated by improvements in transportation. The
expansion of Europe in the sixteenth century expedited the spread of
syphilis, while growing international air travel, urbanization, and the
construction of roads has accelerated the transmission of HIV in Africa,
Asia, and Latin America. Both diseases are spread primarily by
heterosexual intercourse. It is true that AIDS was first identified in
male homosexuals and intravenous drug users. Nevertheless, today the
primary cause of the worldwide spread of HIV is heterosexual
intercourse. Unfortunately, both syphilis and HIV can also be contracted
congenitally, as the fetus develops in the uterus.

As with syphilis, the sudden emergence of AIDS triggered intense debate
over the origin of the disease. Some early theories viewed AIDS as a
punishment, either natural or divine, for deviant behavior such as
homosexuality and drug abuse. Other theories have postulated that HIV
was developed in government germ warfare laboratories and had somehow
accidentally "escaped." Those attracted to conspiracy
theories agreed that the virus was the product of a secret biological
warfare project, but they argued that its release was deliberate, not
unintentional. Still others have theorized that HIV was the inadvertent
result of a medical procedure. Medical historian Edward Hooper, for
example, has suggested that the virus was spread to humans through an
African oral polio vaccine developed in the late 1950s. This vaccine was
grown in fluid containing kidneys of chimpanzees, some of which might
have been infected with an animal form of HIV. Throughout the 1990s,
however, an increasing number of researchers adopted the hypothesis that
HIV was one of those diseases, such as dengue fever (a tropical disease)
and the liver disease hepatitis B, that originated in other species.
Today, based especially on the work of Beatrice Hahn, the scientific
community widely accepts the view that HIV developed first in
west-central Africa where humans, when butchering chimpanzees for meat,
were infected with an animal version of the virus which closely
resembles the HIV now plaguing us.

—Robert Hendrick

KEY TERMS

CHANCRE:

A dull, red, insensitive ulcer of sore, usually at the site at which the
infectious organism, in this case, the syphilis-causing bacterium,
enters the body.

CONGENITAL:

Adisease or condition developed by a fetus in the uterus rather than
being acquired through heredity. Syphilis can be acquired congenitally.

LEPROSY:

A chronic and contagious infection caused by a bacillus (rod-shaped)
bacterium; the symptoms of this infection include skin and bone lesions
or sores.

LITHOPEDION:

An extremely rare and fatal occurrence related to the extrauterine
formation of a fetus in the abdominal cavity. Following the
fetus's death, severe calcification results in lesions on its
skeleton.

PALEOPATHOLOGY:

A branch of anthropology and medicine dealing with the analysis of
skeletal remains, concentrating on the structural changes produced by
diseases.

PINTA:

A tropical skin disease caused by a spirochete which is
indistinguishable from the treponema responsible for syphilis and yaws.
It usually develops in childhood and is spread by skin contact, and not
through sexual intercourse.

PLAGUE:

A contagious and often fatal epidemic infection caused by a bacterium;
it is spread from rats to humans through flea bites.

SPIROCHETE:

A general term for any of the slender, spiral-shaped, and mobile
bacteria of the order Spirochaetales.

YAWS:

A tropical disease caused by a spiro-chete which is indistinguishable
from the treponema responsible for syphilis and pinta. It usually
develops in childhood and is spread by skin contact, and not through
sexual intercourse. Like syphilis, the disease results in bone lesions.

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